Cross-omics analysis revealed gut microbiome-related metabolic pathways underlying atherosclerosis development after antibiotics treatment

Ben Arpad Kappel, Lorenzo De Angelis, Michael Heiser, Marta Ballanti, Robert Stoehr, Claudia Goettsch, Maria Mavilio, Anna Artati, Omero A. Paoluzi, Jerzy Adamski, Geltrude Mingrone, Bart Staels, Remy Burcelin, Giovanni Monteleone, Rossella Menghini, Nikolaus Marx, Massimo Federici

Research output: Contribution to journalArticlepeer-review


Objective: The metabolic influence of gut microbiota plays a pivotal role in the pathogenesis of cardiometabolic diseases. Antibiotics affect intestinal bacterial diversity, and long-term usage has been identified as an independent risk factor for atherosclerosis-driven events. The aim of this study was to explore the interaction between gut dysbiosis by antibiotics and metabolic pathways with the impact on atherosclerosis development. Methods: We combined oral antibiotics with different diets in an Apolipoprotein E-knockout mouse model linking gut microbiota to atherosclerotic lesion development via an integrative cross-omics approach including serum metabolomics and cecal 16S rRNA targeted metagenomic sequencing. We further investigated patients with carotid atherosclerosis compared to control subjects with comparable cardiovascular risk. Results: Here, we show that increased atherosclerosis by antibiotics was connected to a loss of intestinal diversity and alterations of microbial metabolic functional capacity with a major impact on the host serum metabolome. Pathways that were modulated by antibiotics and connected to atherosclerosis included diminished tryptophan and disturbed lipid metabolism. These pathways were related to the reduction of certain members of Bacteroidetes and Clostridia by antibiotics in the gut. Patients with atherosclerosis presented a similar metabolic signature as those induced by antibiotics in our mouse model. Conclusion: Taken together, this work provides insights into the complex interaction between intestinal microbiota and host metabolism. Our data highlight that detrimental effects of antibiotics on the gut flora are connected to a pro-atherogenic metabolic phenotype beyond classical risk factors.

Original languageEnglish
Article number100976
JournalMolecular Metabolism
Publication statusPublished - Jun 2020


  • Antibiotics
  • Atherosclerosis
  • Cross-omics
  • Dysbiosis
  • Gut microbiota
  • Metabolic diversity

ASJC Scopus subject areas

  • Molecular Biology
  • Cell Biology


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